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BUENOS AIRES (Reuters Health) - After obese men have gastric bypass surgery, their testosterone levels almost double in the following year, according to a study reported here at the XIII World Congress of the International Federation for the Surgery of Obesity (IFSO).

Principal investigator Dr. John Morton, of Stanford University Medical Center, California, said that the degree of the increase was "unexpected" and might explain at least partially why many male patients have a restoration of erectile function and sexual drive once they lose weight.

"The improvement of male sexuality after surgery is multifactorial," Morton told Reuters Health. "But testosterone is the main physiological driver of sexual function."

The researchers studied 48 severely obese men (average BMI, 48) before and after weight loss surgery.

Serum total testosterone levels were below normal in 50 percent of the patients before the surgery. After the procedure, average testosterone concentrations rose significantly.

Virtually all of the men had testosterone levels in the normal range after 1 year.

"I expected only some improvement, in the range of 30 percent, not 100 percent," Morton admitted.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - When doctors tell patients with high blood pressure to get some exercise, most of them listen -- yet too few doctors are doing so, a new study suggests.

Using data from a government health survey, researchers found that only one-third of U.S. adults with high blood pressure said their doctors had counseled them on getting regular exercise.

But of those who did get such advice, 71 percent followed it -- and had lower blood pressure than their counterparts who remained inactive, the investigators report in the journal Ethnicity & Disease.

"The blood pressure reduction was ... unexpected, as this was not a trial to determine whether exercise would reduce blood pressure," lead researcher Dr. Josiah Halm, of the University of Wisconsin School of Medicine, said in a statement.

Doctors, he said, should be encouraging exercise as a way to manage high blood pressure, even if they think they do not have time for such a conversation.

"Clinicians will always decry not having enough time to counsel, but a method of using a prescription pad with exercise recommendations as suggested in the study will help solve this quandary," Halm said.

The findings are based on a federal health survey that included 4,686 U.S. adults with high blood pressure. Of these participants, 33 percent said their doctor had told them to exercise regularly to help lower their blood pressure.

Among people who'd received this advice, Halm's team found, 71 percent said they'd heeded it -- and their blood pressure was several points lower, on average, than men and women who had not taken up exercise.

This does not prove that exercise was responsible for the lower blood pressure. However, the researchers point out, other studies have found that exercise does cut elevated blood pressure, even in the absence of weight loss.

Halm and his colleagues suggest that doctors think about exercise as a prescription, and actually write down on a prescription pad the type, intensity and duration of exercise each patient should try.

SOURCE: Ethnicity & Disease, Summer 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Substances called heterocyclic amines (HAs) found in cooked meat and fish don't appear to boost a woman's risk of developing breast cancer after menopause, Swedish researchers report.

However, low intake of these substances combined with high consumption of omega-6 polyunsaturated fatty acids (PUFAs), which are found in most types of vegetable oil, may indeed increase the likelihood that postmenopausal women will develop breast cancer, Dr. Emily Sonestedt, of Lund University, Malmo, and her colleagues found.

"The interaction in the present study between omega-6 PUFAs and HAs is not easily explained, and points toward the importance of examining the impact of food patterns rather than the influence of single dietary factors," Sonestedt and her team state in the October 1 issue of the International Journal of Cancer.

HAs form in meat or fish cooked at high temperatures, and have been tied to breast cancer in rats. Rats fed a fatty diet having a high omega-6 content developed even more tumors in response to dietary HAs than rats given a low fat diet.

Sonestedt's team examined whether HA consumption was related to breast cancer, and whether omega-6 PUFA intake played a role in this relationship, in women enrolled in the Malmo Diet and Cancer study.

The cohort included 11,699 women 50 and older. During follow-up, which averaged about 10 years, 430 of the women were diagnosed with breast cancer.

Women who consumed the most HAs were at no greater breast cancer risk than those who consumed the least, the researchers found. However, in women with low HA consumption, high omega-6 PUFA intake increased the likelihood of being diagnosed with breast cancer.

A previous analysis of data from this study had found high blood fats and high insulin levels -- both of which have been linked to breast cancer -- in women who consumed lots of low-fiber bread, Sonestedt and her team note. This could help explain the relationship in the current study, because women with low HA consumption ate more bread, cookies and cakes, the researchers say.

They conclude, based on their research, that a diet "very high in omega-6 PUFA may promote breast cancer development."

SOURCE: International Journal of Cancer, October 1, 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Black women who undergo tubal sterilization to prevent future pregnancies are more likely than their white counterparts to regret the decision, a new study suggests.

Tubal sterilization is a form of surgery that closes off the fallopian tubes, which carry eggs to the uterus. While the procedure is a highly effective method of birth control, the downside is that it's essentially permanent.

It is possible to reverse tubal sterilization in some cases, but the reversal surgery is complicated, often unsuccessful and usually not covered by health insurance. Therefore, few women have it done.

However, studies suggest that a substantial number of women would have their tubal sterilization reversed if they could; research shows that up to roughly one-quarter of women have some post-surgery "regret."

The new findings, reported in the journal Fertility and Sterility, suggest that black women are more likely to doubt their decision.

Researchers found that among women older than 30 who had their "tubes tied," black women were two to three times more likely than white women to say they would have the procedure reversed if they could.

The reasons for the racial discrepancy are not clear, according to the researchers, led by Dr. Sonya B. Borrero of the University of Pittsburgh School of Medicine.

Doctors' counseling could be one factor, they speculate, if they are more likely to suggest tubal sterilization to black women than to white women.

Another possible factor, Borrero and her colleagues note, is the fact that black women are more likely than white women to change partners later in life. Meeting a new partner could make a woman re-think her decision on family planning, the researchers point out.

More studies are needed to sort out the reasons for the racial disparity, according to Borrero's team. In the meantime, they say, doctors should be aware of the higher rate of regret among black women and take this into account when they are counseling patients on tubal sterilization.

SOURCE: Fertility and Sterility, August 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Low-income women who receive free mammography screening still shoulder some personal costs to have the procedure -- which may help explain continuing disparities in breast cancer screening, results of a U.S. government study suggest.

In the U.S., a federally funded project called the National Breast and Cervical Cancer Early Detection Program covers the costs of breast and cervical cancer screening tests for women who are at or below 250 percent of the federal poverty line.

However, research indicates that only 13 percent of women who are eligible for mammograms under the program actually get one -- a shortfall that is likely contributing to the ongoing mammography gap between insured and uninsured U.S. women.

One potential reason that eligible women are not getting mammograms under the federal program is that despite the fact that the test is free, women still incur personal costs, including the costs of transportation or child care, as well as lost wages from taking time off from work.

In the new study, researchers at the Centers for Disease Control and Prevention tried to estimate what those costs might be for the typical low-income woman.

Using survey data from 1,870 women who participated in the screening program, the researchers found that for women with an annual income of less than $10,000, the personal cost of one mammogram was $17, on average. The cost of 10 screenings over the years would be about $108, while 25 screenings would amount to $262.

Those figures were all higher for women earning between $10,000 and $20,000 per year -- with a one-time screening costing $31 and 25 screenings costing $475.

These numbers might seem modest, but for a low-income woman, they "could be substantial," Dr. Donatus U. Ekwueme and colleagues write in the journal Cancer.

Policymakers are considering expanding the cancer screening program. But as they do, Ekwueme's team writes, "they should also develop strategies to offset personal costs incurred participants."

In general, experts recommend that women have a mammogram every one to two years, beginning at the age of 40.

SOURCE: Cancer, August 1, 2008.

Copyright © 2008 Reuters Limited.